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The Bariatric Surgical Program provides comprehensive pre-operative, peri-operative, and post-operative surgical care led by an interdisciplinary team. The focus of this program is the treatment of obesity and obesity-related health conditions, safe weight management, and healthy lifestyle changes.

In order to be referred to the Surgical Program, patients will require a physician's referral.

Patients who meet the eligibility criteria are assigned to a Bariatric Centre of Excellence (BCoE) or Regional Assessment and Treatment Centre (RATC).

Eligible patients will be contacted directly by their assigned bariatric centre to attend an orientation session, followed by comprehensive screening and assessment by the interdisciplinary bariatric team to assess their appropriateness for surgery. Intensive education and nutritional counseling are provided prior to surgery. Following bariatric surgery, patients are monitored closely within the first year and thereafter within a shared care model with the primary care practitioner and the Bariatric Centre of Excellence.

The OBN has established standardized care paths based on current evidence and best practice that outline the minimal tests/assessments required pre-operatively for all bariatric patients in Ontario. Assessments may vary from person to person, depending on the individual and their health care needs in order to optimize health prior to bariatric surgery.

Eligibility:

  • 18 years of age and older
  • BMI greater than or equal to 40
  • BMI greater than or equal to 35 but less than 40. With at least one of the following comorbidities (as determined by your physician):
    • Coronary heart disease
    • Type II Diabetes mellitus
    • Hypertension
    • Diagnosed sleep apnea
    • Gastroesophageal Reflux Disease (GERD)

Ineligibility (not limited to):

  • Current drug or alcohol dependency (within 6 months of referral)
  • Recent major cancer (life threatening, within last 2 years)
  • Untreated or inadequately treated psychiatric illness

Before surgery, patients' care path includes:

  • Program Orientation (Group Session)
  • Interdisciplinary Bariatric Team Assessments which includes patient visits with:
    • Registered Dieticians
    • Social Workers
    • Registered Nurses and/or Nurse Practitioners
    • Medical Internists and other specialists (i.e. Psychology/Psychiatry) as deemed necessary
  • Pre-Operative Testing involving routine blood work and additional diagnostic testing based on patients' individual medical needs. These diagnostic tests may include:
    • Ultrasound
    • Upper gastrointestinal series
    • Gastroscopy
    • Colonoscopy
    • Helicobacter Pylori Bacteria T
    • Pulmonary Function Tests
    • Cardiac Imaging
    • Cardiac Stress Test
    • Electrocardiogram
    • Sleep Apnea Study
  • Bariatric Surgery Education Sessions (usually done in group format)
  • Surgeon Consult and Consent
    • Patients may be on a low-calorie meal replacement at patients' own expense for 2-3 weeks prior to surgery
  • Anesthesia Pre-Operative Assessment
  • Surgery scheduled

After surgery, patients' care path includes:

  • Post-operative visit at Week 1
  • Follow up assessments at the following time intervals:
    • 1-month post-op
    • 3 months post-op
    • 6 months post-op
    • 1-year post-op
    • Annually up to 5 years post-op

Note: Patients' pre-operative and post-operative care plan may also include additional one-on-one intervention or visits with interdisciplinary team members, based on individual needs

The Bariatric Surgical Program provides comprehensive pre-operative, peri-operative, and post-operative surgical care led by an interdisciplinary team. The focus of this program is the treatment of obesity and obesity-related health conditions, safe weight management, and healthy lifestyle changes.

 

The Bariatric Surgical Program provides comprehensive pre-operative, peri-operative, and post-operative surgical care led by an interdisciplinary team. The focus of this program is the treatment of obesity and obesity-related health conditions, safe weight management, and healthy lifestyle changes.

 

The Bariatric Surgical Program provides comprehensive pre-operative, peri-operative, and post-operative surgical care led by an interdisciplinary team. The focus of this program is the treatment of obesity and obesity-related health conditions, safe weight management, and healthy lifestyle changes.

 

Frequently Asked Questions

For all Medical Programs, the focus is to help patients achieve medically acceptable weight loss in order to improve their co-morbidities and quality of life. The programs focus on helping patients achieve a healthier state of wellness by providing knowledge and life skills to change their eating and coping behaviours, and develop alternative lifestyles that promote healthy eating, physical activity, and healthy living.

The program is funded by the MOHLTC per patient, for a period of 1 year. Patients are then transitioned back to the community to their Primary Care Provider. Patients with severe comorbidities may return into the program based on availability and wait times.

The Medical Program is a 1-year commitment for patients. 

Patients receive active treatment (meal replacement) for 6 months followed by a 6-month intense maintenance program. 

Overweight: 10% to 20% above the person's "desirable" body weight 
 
Obesity: 20% or more than the person’s "desirable” body weight. It is an increase in body weight beyond the limitation of skeletal and physical requirements, as the result of excessive accumulation of body fat.

Super Obesity:40% or more than the person’s "desirable” body weight. It is an excess of body fat, or weight of 45.4 kilograms (100 pounds) over ideal body weight, that increases the risk of developing cardiac and endocrine disturbances, including coronary artery disease and diabetes mellitus, as well as some kinds of cancer.

Body Mass Index (BMI) is a measurement of weight in relation to height. BMI is calculated by dividing your weight in kilograms by the square of your height in meters. 

Excess Body Weight (EBW) is a measurement of current weight in relation to the ideal weight which is based on age and height. The amount of weight in excess of one's ideal body weight is the calculated EBW. 

Patients are informed at Orientation that attendance is mandatory.  
 
If a patient misses a scheduled intervention or group class due to illness, planned vacation, or extenuating circumstances, patients are encouraged to arrange a follow-up session with their bariatric clinic to review missed content.